1 Start 2 Complete
Please give your family/surname
Please give a contact number we can phone you on during the day Monday-Friday
If you can, please give us information about the type of service your issue or question is about.
Please give the name of the hospital, GP practice or other service as this will help us with your enquiry
Please give us enough information to understand the issue you have. We may be able to help you straight away or send you information that can help you. If we can’t help straight away we will contact you to discuss the issue further.
Please say how you found out about us
About you
We collect information about the people who contact us so that we can check that we reach different communities, genders and age groups
Consent and permission
In order to provide you with information we record your personal contact details and information about your query. This also helps us if you return to us with any more questions and to check what people think of our service. We do not sell your information. We will only pass on your information to external organisations that could help you if you give us specific consent. We keep logs of issues raised with Healthwatch Coventry. When we do this we will not include your name, address or any other personal details and we take steps to make sure any examples of experiences of services we use are not identifiable.